Management of Anorexia-Cachexia in Late Stage Lung Cancer Patients

Abstract

Nutritional deficiencies are experienced by most adults with advanced lung cancer during the course of their disease and treatment. Well-nourished individuals tolerate cancer treatment with less morbidity, mortality, and increased response to treatment as compared to those who are malnourished. Novel anti-cancer therapies cause many deficits that impact nutritional and functional status during the treatment process. Nutritional deficits include weight loss, malnutrition, and anorexia-cachexia. Anorexia-Cachexia is complex, not well understood and seen in many solid tumors in late stage disease. Assessing adequate nutrition is one of the most challenging problems for nurses, their patients and patient's families. The purpose of this review is to define and describe cancer anorexia-cachexia in late stage lung cancer, through case presentation, and to describe palliative strategies for prevention, assessment, and management in the palliative care setting. Early assessment for nutritional imbalances must be done regularly with re-evaluation for intervention effectiveness and should continue throughout the illness trajectory. Management of adverse effects of cancer and cancer-related treatment is critical to improving quality of life. Palliative care and hospice nurses play a critical role in early assessment, education and prevention to support nutritional needs for patients and their families.

Keywords: Anorexia; Cachexia; Cachexia- Anorexia Syndrome.

Figure 1

Functional Assessment of Anorexia/Cachexia Treatment (facit.org)

Figure 2

EPCR criteria for refractory cachexia ^,

Figure 3

Management of Anorexia/Cachexia by Life Expectancy ^{, , ,}

Figure 4

Anorexia-Cachexia Impacts the Dimensions of Quality of Life^*